Class Notes (836,992)
Canada (510,027)
Psychology (2,075)
PSYCH 257 (141)

Personality Disorders Pt. 2.

14 Pages
Unlock Document

Allison Kelly

LECTURE17 P ERSONALITY D ISORDERS –P ART 2 OF 2 C HAPTER 12 OF TEXTBOOK RECAP: Last Class  The nature of personality disorders o On axis two – more stable and chronic. Disorders that are considered to last a lifetime in most cases  Cluster A PDs o Paranoid, schizoid, schizotypal  Cluster C PDs o Avoidant, dependent, obsessive-compulsive Today’s Outline  Cluster B personality disorders: Emotional, dramatic disorder o Borderline  Notorious for the harm that people suffering can cause to themselves (and others) o Narcissistic o Histrionic o Antisocial  Pose a risk to society – break the law o Summary game – name that PD Borderline PD Overview Characteristics  Unstable emotions o In the course of a day, and even an hour  Patterns of unstable moods, relationships, and impulsive behaviours o Have intense relationships and then all of a sudden they hate that person and wish them dead o Act out in ways that are harmful to themselves (emotionally harmful to others) 1  Profound fear of abandonment o Worry that they will be alone and that they are not loved  Emptiness and poor self-image o Don’t have a strong sense of who they are or what they want o Easily influenced by partner  Difficulties with emotion regulation and distress tolerance  self-mutilation o Difficulty to experience an emotion and cope with it  Not having a strong reaction ** VIDEO**: Girl Interrupted Assessment Interview (YOUTUBE) o Feel like they have no hope DSM Symptoms  Frantic efforts to avoid abandonment  Pattern of unstable relationship characterized by extremes  Unstable self-image  Impulsivity that are self-damaging  Recurrent suicidal behaviour, gestures, or threats, or self-mutilation  Mood instability  Chronic feelings of emptiness  Inappropriate anger  Transient, stress-related paranoid ideation or severe dissociative symptoms o Can include drinking a lot  Jeopardizing their safety o Eating Disorders o Hear voices  Know that they are coming from themselves  Understanding Self Mutilation in BPD video o Way to punish yourself for the impulsivity o Blood is cleansing? o Release of strong feelings o Blood and physical pain is way of validating what went wrong o Cutting themselves, burning themselves, scratching and punching 2 Prevalence & Comorbidity Prevalence  General population o 1-2%: Diagnosed more in females  Psychiatric settings o In patient: 20% o Out-Patient 10%  Females > males Comorbidity  Other PDs o Antisocial, schizotypal, histrionic o Substance related disorders, PTSD, mood disorders o History of abuse Etiology Biological factors  Tends to run in families o Environmental or biological?  Genetics related to impulsivity or lower serotonin  Consensus: Biological doesn’t explain it all Psychological factors  Born with Stronger attachment needs  Impulsivity  Emotional reactivity Social factors  Invalidating environment o Feeling sad as a child optimal validating thing is parent supporting and be warm  Invalidating: “you’re not sad”, not giving them attention  Abuse, neglect, maltreatment o High rates  61% have history of sexual abuse vs. 32% with other personality disorders  90% with BPD have some form of abuse in history 3  Part of the answer? Diathesis-stress model of BPD Treatment Crisis intervention  Dealing with them when they come into ER from suicide attempt Psychotherapy  Dialectical Behaviour Therapy (DBT) o Developed by someone with BPD o People become much less suicidal, fewer visits to ER o Helps a lot with major features  Outcome studies  Treatment of choice Medication  SSRIs o Used to help with low mood  Mood stabilizers  No research to suggest that these on their own will help o Used in conjunction with others 4 Dialectical Behavioral Therapy (DBT) Structure of DBT  Long term: about a year  Weekly skills training session o Focus on skills themselves, not emotions o Teach them to behave and respond in more adaptive, helpful ways  Weekly therapy  24/7 therapist on call o If they have already self harmed by the time they call the therapist, then they can’t get help and can’t talk to therapist for 48 hours  Teaches them to call before harm  Reward for calling for help when they have urge to self harm – commit to not acting out when they feel like it but to cope.  Support for therapists o Work in teams to support each other Therapist qualities and focus  Validation, genuineness  “Radical acceptance” AND change o Acting in a way that says we accept you and that you want to self harm, but we are encouraging change  How can I help you change  Dialectical Therapy Skills training  Mindfulness o Not becoming overwhelmed o Making sense of things  Emotional regulation o Calling therapist  Distress tolerance o That don’t involve self harm o Going for a walk, taking a bath, playing with dog  Interpersonal effectiveness o Ways to resolve conflict without acting out and hating the person 5  Not ending the relationship Summary: BPD  Disorder characterized by emotional deregulation  Environmental ad biological factors  Dialectical therapy helps Histrionic PD Overview Characteristics  Overly dramatic and attention-seeking  Strong need to be center of attention o Dress provocatively, o Talk really eccentrically o Meet them once and they act like your best friends ** Video ** Basic Instinct o Scene when she opens her legs and reveals she is not wearing any underwear is very characteristic of histrionic personality disorder  Use physical appearance to draw attention  Theatrical  Extravagant emotion with rapid shifts, suggesting more shallow than sincere  Overly dramatic 6 Symptoms  Need to be center of attention, uncomfortable when not  Interactions with others – inappropriately sexually seductive or provocative behaviour  Rapidly shifting and shallow expression of emotion  Use of physical appearance to draw attention to self  Style of speech that is highly impressionistic and lacking in detail  Dramatic, theatrical, exaggerated expression of emotion  Suggestible  Thinks relationships are more intimate than
More Less

Related notes for PSYCH 257

Log In


Join OneClass

Access over 10 million pages of study
documents for 1.3 million courses.

Sign up

Join to view


By registering, I agree to the Terms and Privacy Policies
Already have an account?
Just a few more details

So we can recommend you notes for your school.

Reset Password

Please enter below the email address you registered with and we will send you a link to reset your password.

Add your courses

Get notes from the top students in your class.